Falls present a significant risk to older Americans. According to the National Center for Injury Prevention and Control, in the US, falls are the seventh leading cause of death among adults aged over 65 years. Falls are also the leading cause of death from injury among people 65 or older. Two-thirds of those who experience a fall will fall again within six months and approximately 25% of older people who fall die within one year. Nonetheless, the most profound effect of falling is the loss of independent functioning and thus approximately 25 percent of people 75 or older unnecessarily restrict their activities because of fear of falling.

Many factors contribute to the creation of a fall or to creating an opportunity for a fall. Among the environmental factors are home hazards like clutter or loose rugs, poor lighting, lack of bathroom safety and inadequate footwear. Additionally, busy street, elevated walkway, lack of handrail can create an opportunity for a fall. Medications – or, more specifically, psychoactive medications or polypharmacy (combination of multiple medications) – may also present or elevate a risk of fall.

Personal factors play an even larger roll in the creation of an opportunity fall a fall. Chief among these are changes in vision and hearing, changes of reflex, muscle mass & body fat and declining gait and balance. Subsequent low mobility or fragility, lower extremity weakness and poor grip strength may both contribute to creating a fall and prevent the body from properly responding to it once the fall is initiated. Additional contributors like cognitive Impairment, chronic Illness, heavy drinking and previous falls may also facilitate a fall.

The fall risk factors are summarized in and are nicknamed “I Hate Falling”:

I – Inflammation/deformity of joints
H – Hypotension
A – Auditory and vision abnormalities
T – Tremor
E – Equilibrium problems
F – Foot problems
A – Arrhythmia, heart block, valvular disease
L – Leg length discrepancy
L – Lack of conditioning
I – Illness
N – Nutrition
G – Gait Disturbance

Key to a successful fall prevention effort in adults is the reduction in fear of falling. Removal of clutter, installation of proper lighting, use of proper footwear and use of handrails can significantly reduce the risk of falls. Physical therapists offer regular exercise programs that can help keep the body in good condition. Additional programs offered by physical therapists include therapeutic and balance exercises, pain management, postural and body mechanics training or vestibular and low vision training and may contribute to reducing the risk of a fall.